Human Resources Committee on June 1st, 2021

[The Chair, Liberal, Sean Casey]

Ms. Chabot, you have the floor for six minutes.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

I want to thank both witnesses for their presentations. I must admit that several of the points raised resonated with me, since I used to be a nurse. I think that all the provinces are experiencing the realities described in terms of working conditions, compensation, attraction and retention.

In Quebec, we're quite proud of our achievements. At the height of the crisis, 10,000 personal support workers were hired. They're part of the care team for which we ensured increased compensation. It should be noted that labour laws fall under provincial jurisdiction.

This brings me to a question that [Technical difficulty—Editor]. Quebec and the other provinces have requested support for health care and social services. They have jurisdiction over service delivery, care organization, labour laws and regulations. The provinces have requested a significant increase in health transfers. As we know, 80% of health care spending is based on the workforce. To provide quality services, workers are needed.

Ms. Porter, do you agree that the federal government should transfer the money needed for health care to the provinces?

[Dr. Michelle Porter]

More funding is absolutely required across the board, although I'm not going to get into which jurisdiction should be providing those funds. We're all, as individuals, taxpayers and the money has to come from somewhere, but we'll need to see more funding in the system, in addition to the things we've already talked about.

We also know that many surgeries have been delayed. There are a lot of older people who need surgeries going forward, whether for cataracts or knee replacements, and there are even more dire situations right here in Manitoba with heart surgeries and of course with long-term care. I mentioned the therapies that are not necessarily available. Some people can't afford to pay for physical therapy to recover from COVID, for example.

Certainly a lot more funding is needed within the health care system going forward.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Ms. Porter, you have conducted several studies and made a number of observations regarding seniors.

In your experience, are there additional costs and expenses associated with illness that may contribute to increased stress and anxiety among seniors aged 65 to 75?

[Dr. Michelle Porter]

I'm sorry. Was that directed to me?

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Yes.

[Dr. Michelle Porter]

Your question was around whether this whole situation has created more problems in terms of anxiety and mental health. Yes, certainly.

I wouldn't say that's across the board. I think it's a bit of a stereotype to think that all older people have fared poorly during the pandemic. I think we have some very resilient older people who have actually done quite well during this. They've had life experience. They've potentially gone through scenarios like this. I know a 96-year-old woman. She's not happy with the situation as it has been, but she has been quite resilient. She's had a lot of struggles in her life.

Certainly, there are older people who have suffered, particularly those who are on low incomes, who are disconnected from their communities or who are living in apartment buildings. They don't feel safe even leaving their rooms.

Yes, dealing with the mental health challenges that the pandemic has posed certainly will be a reality going forward as well.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

In your opinion, Ms. Porter, are there seniors aged 65 to 74 who spend over 30% of their income on housing?

[Dr. Michelle Porter]

There are people on the low-income scale who certainly need more support. Any time programs are being designed for older people, I think it would make a lot of sense for those programs to be targeted to those who are in great need.

Again, there's a lot of heterogeneity in the older population in terms of their financial circumstances. There are many older people in that age bracket who are still working, for example, and who are still paying taxes, but there are people who are younger, particularly people who might have faced lifelong health challenges and things, who are not able to work, are in that lower age bracket and might not be very financially well off.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Porter.

Thank you, Ms. Chabot.

Next is Ms. Gazan, please, for six minutes.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you so much, Mr. Chair.

My first question is for Dr. Porter.

I'm sure you would agree that the treatment of seniors during the pandemic has been pretty horrible and less than adequate. Much of this has had to do with the poor conditions in long-term care centres and generally inadequate programs and systems for seniors.

I would argue that this is a clear indication of an issue of ageism that we certainly have in this country, and I think it's important that we root out these issues to ensure that all seniors can live with dignity and security. Can you tell us more about the role of ageism in the pandemic and how you would suggest creating societies and systems that don't perpetuate ageism?

[Dr. Michelle Porter]

That's a big topic, but an important one.

We saw right from the very beginning of the pandemic that ageism was seeping in, even by people who weren't likely intending to be ageist. We heard messages such as, “Oh, it's not that serious because it only affects older people.” There, we see the seeping in right away at the beginning, that it really isn't that concerning because it's not affecting everyone in society.

Implicitly, although we might not even realize it, even gerontologists can see it surfacing on occasions, that we have this differential thinking about people by their age. This is something that is pervasive in society, so it's not something that's going to be easily overcome.

I think you're correct in your assertion that in the fact that long-term care did not do well, there is certainly an aspect of ageism and ableism that existed, which was why they were kind of left on their own to try to fend for themselves.

One, we have to have an awareness campaign, to begin with, that this even is an issue, because most people in society realize that there are many forms of discrimination and they realize the harms from those forms of discrimination, but they do not understand [Technical difficulty—Editor] as a society. It also has implications for work. We've seen that, in many instances, older people might have lost jobs through the pandemic, and older people will likely have a harder time being hired again because ageism is also pervasive in hiring, training, and even in firing employees.

It is a huge issue for our society and I think it would be worthwhile for Canada, as a country, to join the WHO in combatting ageism. I understand that the National Seniors Council has this as one of its target areas, but I don't think we can underestimate how important this is. I think it also affects our students at the university and the topics they choose to study, because it is not seen as necessarily a good role to be in, in terms of looking after older people. Across the board, we have to try to overcome this.

[Leah Gazan, NDP, Winnipeg Centre, MB]

As we know, during the pandemic, certain groups have been hit harder, and it certainly has shone a light on racial, gender, class and other inequalities that we have in society. These societal inequalities had lethal consequences for groups forced to live in poverty and in vulnerable situations. At the same time, I would argue that, in terms of the wealthy, many people were profiteering off the pandemic and getting richer. I've taken great offence to it.

Can you tell us about the pandemic's uneven effects across all social groups among seniors?

[Dr. Michelle Porter]

I don't have a lot of specific data that I can cite, but certainly we've seen in Winnipeg where there are lots of individuals who have food insecurity issues. Right now, in this third wave that we're experiencing, they're having to be provided with emergency kits, whereas, as I said, I hear about other older people and they are financially stable and are able to weather this quite well. People are taking up new hobbies. There is a great range of effects of this pandemic on older people.

There's a tendency to think of them as one group and having one effect, but certainly through the various community organizations that are operating within our communities, we hear about these divides, and even just by the fact of where people are living, the physical buildings in which they live. If you're living in a house, you most likely have a much better quality of life because you're able to come and go potentially without any fear that you're going to have a possibility of contracting the virus, as compared to—

[Leah Gazan, NDP, Winnipeg Centre, MB]

Sorry. I have one second left.

Would you say it's difficult to give that assessment because there has really been no race-based data and gender analysis during the pandemic to give a clear response to that, and that it's needed?

[Dr. Michelle Porter]

Yes, I do, and—

[The Chair, Liberal, Sean Casey]

Respond briefly, please.

[Dr. Michelle Porter]

In a lot of aspects of the data, at least that we're receiving here in Manitoba, which I assume is filtering through federally, we might have race-based data, and we might have age-based data, but we don't have a lot of the more fine-tuned data across all individuals. Hopefully, we'll be able to see that as researchers and people will be able to study it.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you so much.

[The Chair, Liberal, Sean Casey]

Thank you.

Mr. Tochor, you have five minutes, please.

[Corey Tochor, Conservative, Saskatoon—University, SK]

Thank you, Chair.

I'd like to thank the witnesses for their presentations, for being here today and for the good work they're doing to understand what we're facing with such an important segment of our population.

We touched on aging in place and aging at home or living at home. Just to start off, I believe that after this, once we're on the other side of COVID-19, there's going to be an even larger percentage of seniors who aren't going to want to move into seniors housing. They are going to want to age in place. As much as I think there was probably a large demand before the pandemic, I think that afterwards there are going to be some lingering effects and some fear factors are going to creep into it.

Do you believe that this trend is accurate? Is that going to happen after?

[Dr. Michelle Porter]

I can answer that if you'd like.

Yes, I absolutely think that. In part, generationally, we see the age cohorts changing. Their lifestyles have been very different from that perspective, I think, even pre-pandemic, yes, in terms of even what families will encourage older people to do in terms of their living environments.

Clearly, that's going to have been affected by the pandemic. We hear in our studies, when people are talking about long-term care, that there is absolutely even more fear than there was in the past. There are going to be people who want to live in their own homes and in their own neighbourhoods. We need to really make sure that we are not just replacing long-term care living with caregivers becoming overburdened and them having to take everything on.

We need to make sure that we have more home care available, as well as a lot more community supports. There's a lot more than just transportation, but that's one that sometimes gets forgotten because when we say “age in place”, I think people think that the person's never going to leave that place. There are many reasons why people want and need to leave the place that they're actually living in.

[Corey Tochor, Conservative, Saskatoon—University, SK]

Thank you.

One the concerns I have is what Canada will look like after this.

I'll carry on with Ms. Porter.

You brought up the delayed surgical care. In general, health care has been delayed for the last 16 months in so many cases. I'm very fearful of the state of finances in provincial capitals across Canada. There's a record amount of debt and the ability for provinces to provide health care going into the future is going to be very challenging.

If there are decisions to be made provincially, I'm concerned about the financial strength of the provinces to meet that challenge. I'm wondering if you have any idea if there's one segment of delayed care that we should be watching afterwards for seniors.

[Dr. Michelle Porter]

Oh my goodness, in terms of surgeries or therapies, there's a whole host.

If we think from a primary prevention point of view, that was what I was kind of trying to get at in my original statement around the physical therapies and exercise programming. I come from that background in kinesiology. It is a primary prevention means for so many different health conditions but, as I mentioned, many older people live in apartment buildings. They have barely moved at all through these various waves of the pandemic. I think a good place for some money to be spent is on primary prevention for falls and for making sure metabolic health is good. That would be where I would put some money after this pandemic or going out of this pandemic.

[Corey Tochor, Conservative, Saskatoon—University, SK]

That's on the chronic side, but there are going to be emergency needs. I'm wondering if there are any statistics.

I won't say that it's from a reliable source, but there are concerns about delayed cancer diagnoses. We know that with a delayed diagnosis for patients, it's going to be a poorer health outcome. There's cancer and there's hypertension, which is a ticking time bomb out there. It is kind of related to the inactivity of some of our seniors. Is there no research that you know of or no statistics on what we are looking at afterwards?